Provider Demographics
NPI:1447709597
Name:CHRISTENSEN, KATHRYN JO (NP-C)
Entity type:Individual
Prefix:
First Name:KATHRYN
Middle Name:JO
Last Name:CHRISTENSEN
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 E LINCOLN ST
Mailing Address - Street 2:
Mailing Address - City:HENDRICKS
Mailing Address - State:MN
Mailing Address - Zip Code:56136-9598
Mailing Address - Country:US
Mailing Address - Phone:507-275-3121
Mailing Address - Fax:507-275-3194
Practice Address - Street 1:501 E LINCOLN ST
Practice Address - Street 2:
Practice Address - City:HENDRICKS
Practice Address - State:MN
Practice Address - Zip Code:56136-9598
Practice Address - Country:US
Practice Address - Phone:507-275-3121
Practice Address - Fax:507-275-3194
Is Sole Proprietor?:No
Enumeration Date:2016-09-30
Last Update Date:2016-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNCNP4829363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily